2019-12-06T07:05:22-06:00 2019-06-30 990 2018-07-01 455440305 FAYETTE PHYSICIAN NETWORK INC % CORPORATE ACCOUNTING FAYE 4126472345 600 GRANT STREET 58TH FL CORP TAX PITTSBURGH PA 15219 ROBERT BLOSAT TREASURER 4126472345 2019-12-03 128.147.28.67 25115620193405000000 2019-12-06 P 231EC4D7168BEF6AFB68A704FA695A7F80752940 231EC4D7168BEF6AFB68A704FA695A7F80752940 2018 2020-04-17 16:48:07Z Robert Blosat C/O 600 GRANT ST CORPTAX 58FL PITTSBURGH PA 15219 22835889 false X N/A X 2012 PA FAYETTE PHYSICIANS NETWORK, INC. OPERATES MEDICAL PRACTICES THAT PROVIDE MEDICAL SERVICES PRIMARILY TO THE RESIDENTS OF FAYETTE COUNTY PENNSYLVANIA AND SURROUNDING AREAS. 6 6 0 0 0 0 0 21544060 22835889 0 0 0 0 21544060 22835889 20000 0 0 0 23554387 25328061 0 0 0 16370919 18338984 39945306 43667045 -18401246 -20831156 4461207 2458453 8544234 6806264 -4083027 -4347811 X FAYETTE PHYSICIAN NETWORK,INC. OPERATES MEDICAL PRACTICES THAT PROVIDE MEDICAL SERVICES PRIMARILY TO THE RESIDENTS OF FAYETTE COUNTY PENNSYLVANIA AND SURROUNDING AREAS. THE AREA IT SERVES IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. SEE SCHEDULE O. false false 40916377 22835889 SEE SCHEDULE O. 40916377 true false false false false false false false false false true false false false true false false false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false true 71 0 true 0 true false false false false false false false false false false X 6 6 false false true false true true false true true false false true true true true true true false false false PA X CORPORATE ACCOUNTING 4126472345 600 GRANT STREET 58TH FLOOR PITTSBURGH PA 15219 X X Steven Handy Chairman 1.0 1.0 X X 0 0 0 Robert Blosat TREASURER 1.0 1.0 X X 0 0 0 Linda Burstynowicz Board Member 1.0 1.0 X 0 0 0 Marshall Webster MD Board Member 1.0 1.0 X 0 0 0 Barbara Weiss Board Member 1.0 1.0 X 0 0 0 Mike Grace President 1.0 1.0 X X 0 0 0 Mark Dillion J 101218 Secretary 1.0 1.0 X X 0 0 0 Dorothy Knight Executive Administrator 40.0 0.0 X 0 183497 20977 Babak Movassaghi MD Physician 40.0 0.0 X 585603 0 0 Vivek Sharma MD Physician 40.0 0.0 X 494455 0 0 Brandon Ball MD PHYSICIAN 40.0 0.0 X 463157 0 0 Josef Vanek MD Physician 40.0 0.0 X 469527 0 0 Earl Moss MD Physician 40.0 0.0 X 448954 0 0 2461696 183497 20977 51 false true true Staff Care Inc PO Box 281923 ATLANTA GA 30384 Physician Services 750999 Fusion Healthcare Staffing LLC PO Box 202056 DALLAS TX 753202056 Physician Services 706467 WPA EMERGENCY MEDICINE STAFFING LL 513 RT 259 LIGONIER PA 15658 Physician Services 116649 Locum Tenenscom PO Box 405547 ATLANTA GA 303845547 Physician Services 100266 4 0 PATIENT CARE REVENUE 621110 22622349 22622349 0 0 PROGRAM SERVICE REVENUE 621110 213540 213540 22835889 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22835889 22835889 0 0 0 0 0 0 0 0 22485355 22225280 260075 220101 217555 2546 1612222 1593574 18648 1010383 998696 11687 0 62328 62328 0 0 0 0 42058 42058 8046 8046 386663 294388 92275 8492 8492 0 667577 667577 44694 43340 1354 0 1134 1134 0 0 111906 111906 1005844 993707 12137 PURCHASED SERVICES 3283300 1276252 2007048 OTHER MISC. EXPENSE 10487740 10205170 282570 0 SUPPLIES 81654 81654 BAD DEBT 1622111 1622111 525437 525437 43667045 40916377 2750668 0 X 3675 3675 1698255 -153055 0 0 1884548 1474084 0 0 0 0 0 0 0 0 350090 383708 2072867 1348639 524639 724228 0 0 0 0 0 0 0 0 0 25813 4461207 2458453 2921995 2156174 0 0 91453 133589 0 0 0 0 0 0 0 0 0 0 5530786 4516501 8544234 6806264 X -4083027 -4347811 0 0 0 0 -4083027 -4347811 4461207 2458453 X -20831156 20566372 X false false false X 328632 39383 289249 878266 718088 160178 802186 591167 211019 63782 63782 724228 0 OTHER CURRENT LIABILITIES 267222 DUE TO EXEMPT AFFILIATES 4249279 4516501 false false false false false false false true false Dorothy Knight Executive Administrator 0 165013 0 7750 0 10734 0 13934 0 7043 0 204474 0 0 Babak Movassaghi MD Physician 584002 1601 585603 Vivek Sharma MD Physician 492299 2156 494455 Brandon Ball MD PHYSICIAN 458027 5130 463157 Josef Vanek MD Physician 456654 12873 469527 Earl Moss MD Physician 442341 6613 448954 Schedule J Part I, Question 7 Fayette Physician Network, Inc. provides incentive compensation as part of its total compensation program for key employees. This component is based upon the accomplishment of predetermined performance goals and objectives which focus on the achievement of multiple annual and three year individual and group performance criteria in the context of appropriate risk taking. These criteria directly support Fayette Physician Network, Inc.'s mission and include: patient quality and satisfaction, community benefits, operational and financial strength, leadership development, and strategic business initiatives among others. Part III Statement of Program Service Accomplishments Fayette Physicians Network, Inc. (the Network) was formed on June 5, 2012 as a Pennsylvania non-stock, nonprofit corporation. It is comprised of 65 providers at 10 locations. The Network has at all times since its formation been organized and operated for charitable purposes within the meaning of the Internal Revenue Code Section 501(c)(3). The Network is organized and operated to own and operate medical practices that serve the patients of Fayette County Pennsylvania and surrounding areas. As stated in its Articles of Incorporation, the Network shall be operated exclusively for exempt purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code. Specifically, the purpose of the Network is to own and operate medical practices in Fayette County, Pennsylvania. The Network is made of up 4 divisions: Fayette Anesthesia Providers, Fayette Medical Associates, Fayette Specialty Associates, and Hospital Care Associates. The practices provide medical services to residents throughout Fayette County Pennsylvania and surrounding areas to relieve conditions relating to, and to promote the interests of, the health of these various communities. Medical services are provided to the residents of these underserved communities regardless of their ability to pay. The Network is also involved in community education through the Uniontown Hospital (Hospital). These events are open to the public free of charge. They are advertised both on the Hospitals website and in a newspaper that is widely read throughout Fayette County. The practices physicians are critical to these events as they contribute their expertise by serving as speakers, free of charge. Consistent with its charitable mission to meet the health care needs of the residents of the community without regard to their ability to pay, the Networks physician practices adhere to the generous charity care program of the Fayette Regional Health System, called the Safety Net Access Program (SNAP). The SNAP policy is centered on the principle that medically necessary services will be rendered gratuitously to patients that demonstrate financial need and the provision of charity is viewed as the core of the Network, physician practices and the Fayette Regional Health Systems charitable purpose. Part VI Governance, Management, and Disclosure Section A: Governing Body and Management Question 6: Fayette Physician Network, Inc. has two exempt entity members, UPMC Community Medicine, Inc. and Fayette Regional Health System. Question 7A: The two exempt entity members, UPMC Community Medicine, Inc. and Fayette Regional Health System, have the ability to appoint 3 board members each to Fayette Physician Network, Inc. as stipulated in the by-laws of Fayette Physician Network, Inc. Question 7B: UPMC Community Medicine and Fayette Regional Health System, as the members of Fayette Physician Network, Inc., have the right to approve certain actions and transactions of Fayette Physician Network, Inc. The specific transactions that are subject to the approval of the members are stipulated in the By-laws. Section B: Policies Question 11: A full copy of the form 990 was provided to each Board of Directors member prior to filing. Question 12c: Fayette Physician Network, Inc. requires all of its key employees and non-employed personnel to comply with its conflict of interest policies when they engage in Fayette Physician Network, Inc.-related business. This COI policy is that of its exempt member UPMC Community Medicine, Inc. People covered by the policies include: -Fayette Physician Network, Inc. entity board members, board committee members, and corporate officers -Fayette Physician Network, Inc. physicians and non-physician employees who hold a position of influence These people are required to complete a questionnaire at least annually. An electronic form has been developed to capture the data from the questionnaire and to monitor completion. The information, along with other data, is used to capture individual and institutional relationships so that potential conflicts of interest can be identified. If a potential conflict is identified regarding a specific activity the corporate compliance department, with the assistance of the legal department of UPMC, would evaluate the activity in relation to the potential conflict. If a perceived or actual conflict is determined to exist and a decision is made to proceed with the activity, a written plan designed to prevent the conflict from influencing decisions related to the activity is developed. Part VI Governance, Management, and Disclosure Section A: Governing Body and Management Question 4: As of June 27, 2019 UPMC Community Medicine, Inc. transferred its 50% membership interest in Fayette Physician Network, Inc. to Fayette Regional Health System (Fayette) making Fayette the sole member of Fayette Physician Network, Inc. as of this date. Section C: Disclosure Question 19: Upon request, management determines public disclosure applicability. PART VII AND SCHEDULE J SECTION A, OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES. The disclosure for compensation is based on total calendar year 2018 amounts. PART VII SECTION B INDEPENDENT CONTRACTORS The disclosure for independent contractors is based on total calendar year 2018 information. Part XI, Reconciliation of Net Assets Reconciliation of Net Assets Line 9: Other Changes in Net Assets. The amount of $20,566,372 Other Changes in Net Assets represents the transfer from exempt member organizations. Part XI Reconciliation of Net Assets Transfers from Exempt Members 20,566,372 TOTAL 20,566,372